“When Should I Worry About My Child’s Cough?”

A child with a persistent cough can leave you awake all night with worry, but when should the hacking and wheezing become a true cause for concern?

“Coughing is a common ailment among children, with some coughs lingering for weeks before they finally disappear,” said Dr. Sridevi Muppidi, a pediatrician at Memorial Hermann Convenient Care Center in Katy. “Still, coughs are rarely signs of serious illnesses.”

Coughs can be tough to shake, especially for children with immature immune systems and lungs, but the reflex of coughing helps children clear their airways and breathe easier. Most often, children develop coughs from an upper respiratory infection like a cold, but coughs can also be related to acid reflux, asthma, sinusitis and allergic reactions to allergens like pollen and mold.  It’s important for parents to be able to know the warning signs of a troublesome cough so they can decide whether the cough merits a trip to the doctor or if it can be treated at home.

Listen Closely

Some coughs make a distinctive sound that can help a parent or pediatrician identify the cause of the problem. For example, a common viral childhood illness called croup causes a barking cough, which sounds similar to the noises made by a seal. Often when they inhale, children with croup also make a high-pitched or squeaky noise called stridor with symptoms often worsening at night.

“Most cases of croup are relatively mild and parents can apply home treatments like cool-mist humidifiers to help their little ones breathe easier, but occasionally a child may need a special breathing treatment or medicine to help them feel better,” Dr. Muppidi said.

A child who makes a “whooping” sound when he or she breathes deeply may have a more serious illness called pertussis, or whooping cough that can last for weeks if left untreated. This highly contagious infection causes violent and extreme coughing fits that can force a child to vomit or feel exhausted afterward.

To protect against this serious infection, it’s recommended that children receive pertussis vaccinations at 2 months, 4 months, 6 months, 15 months and between the ages of 4 and 6 years. Immunizations can help lessen the severity of symptoms for those who have been vaccinated, but the condition is dangerous for babies. About half of infants who are infected before the age of 1 require hospitalization, according to the U.S. Centers for Disease Control and Prevention.

“We highly recommend that pregnant mothers get a pertussis vaccine in the latter half of their pregnancy to protect their fragile newborn until he or she is able to get their first shots at two months old,” Dr. Muppidi said. “It’s also a great idea for any adult to get vaccinated if they plan to be around the baby because children who get infected with whooping cough often catch it from relatives.”

When to Call a Doctor

While most coughs are relatively benign and will go away on their own, some may require medical attention immediately. Call 911 if your child is choking, has lost consciousness, stopped breathing, has a blue tint to their fingernails, lips, face or tongue, or is struggling so severely to catch their breath that they are unable to talk or grunts every time breath.

Call your doctor if your child is coughing and breathing faster than normal, coughing up blood, vomiting persistently, turning red or purple while coughing, has a high fever, making whooping sounds or has stridor, having trouble swallowing, is wheezing, or otherwise seems very sick and tired. An appointment should also be made if your child has been coughing or wheezing for more than two weeks, even if no other symptoms are present, Dr. Muppidi said.

Any child under the age of 3 months should be taken to see a doctor right away if they have a fever, regardless of how high, or they have been coughing for more than a few hours.

Home Remedies

Since most coughs are viral, they can’t be cured at home, but there are steps that parents can take to help alleviate their child’s suffering. Moist air can help clear a child’s airways so consider running a cool-mist humidifier in the child’s bedroom overnight or fill a bathroom with steam from a hot shower, and then sit with your child for 15 to 20 minutes in the steamy room before bedtime.

Offer your child plenty of water and juice to keep them hydrated and soothe their sore throats. A teaspoon of honey for children over the age of 1 may also provide some relief, but honey should never be given to infants because it can contain bacteria that can cause muscle weakness and breathing problems.

Post-nasal drip can also trigger respiratory irritation. Clear a baby’s nasal passages using a bulb syringe and saline nasal spray, and for older children, encourage them to blow their noses often.

Over-the-counter cough and cold medicine should never be given to children under the age of 4, and a pediatrician should be consulted before administering these medications to children between 4 and 6 years old. The American Academy of Pediatrics says that cough and cold medicines can have serious side effects in young children and pose a risk of an accidental overdose. Cough drops are also not appropriate for children under 4 because they pose a choking hazard.

Most importantly, make sure your child is getting lots of much-needed rest and tender loving care to help them get on the road to recovery.

Should an emergency arise from a cough, the Emergency Centers at Memorial Hermann hospitals or Memorial Hermann Convenient Care Centers are open 24 hours a day to treat patients of all ages. For urgent but non-emergent needs, physicians at Memorial Hermann Urgent Care  see patients from 9 a.m. to 9 p.m., seven days a week. To schedule an appointment at Memorial Hermann Medical Group at Memorial Hermann Convenient Care Center in Katy, call 281.371.1800.

If you or your child are feeling ill and you’re not sure what to do, call the free 24/7 Nurse Health Line. Registered nurses will help you decide what to do.  Language interpreters are available.  Call 713.338.7979 or visit our Nurse Health Line webpage.

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